Introduction: Acute Pancreatitis (AP) is an acute inflammatory disease marked by the auto-digestion of pancreas by the enzymes it secretes. The objective: The objective of this study was to determine which etiology is dominant in causing the most severe necrotic form of AP. Patients and methods: All of the 116 patients included in this study (M.-1 = 2.3:1; mean age: 52 years) were admitted to the Gastroenterology and Hepatology Department of Novi Sad Medical School over a two year period. A thorough clinical exam and C-reactive protein levels were used to assess the severity of the disease. The etiology of the disease was established from a detailed patient history, physical exam and specific laboratory exams. Important aids in detecting the etiology of AP were ultrasonography of upper abdomen, esoduedenoscopy with biopsies and ERCP. Results: show that in a majority of cases (87.93%), AP is a mild, self-resolving disease (57.72%). The most frequent etiology was alcohol (41.4%), followed by hyperlipoproteinemia (24.1%), especially type IV (40.9%) according to Fredrickson. Idiopathic AP was the third most common cause (22.4%) of AP, while billiary etiology was the least common etiology (12.1%) of AP. Severe necrotic pancreatitis was most frequently seen in patients with hyperlipoproteinemia (25.8%) and much less frequently in the patients with alocohol-mediated (8.3%), idiopathic (7.7%) and billiary-mediated (7.1%) AP. Conclusion: Most frequent etiologies of AP were alcohol and hypelipoproteinemia, while the least frequent etiology was billiary related. Most severe form of acute pancreatitis was seen in patients suffering of hyperlipoproteinemia. This information can be very important for monitoring and therapy of the patients with AP.

acute pancreatitis; etiology; clinical signs